Controlled experiments measuring personal exposure to PM2.5 in close proximity to cigarette smoking

Few measurements of exposure to secondhand smoke (SHS) in close proximity to a smoker are available. Recent health studies have demonstrated an association between acute (<2 h) exposures to high concentrations of SHS and increased risk of cardiovascular and respiratory disease. We performed 15 experiments inside naturally ventilated homes and 16 in outdoor locations, each with 2–4 non‐smokers sitting near a cigarette smoker. The smoker's and non‐smokers' real‐time exposures to PM_2.5 from SHS were measured by using TSI SidePak monitors to sample their breathing zones. In 87% of the residential indoor experiments, the smoker received the highest average exposure to SHS, with PM_2.5 concentrations ranging from 50–630 μg/m³. During the active smoking period, individual non‐smokers sitting within approximately 1 m of a smoker had average SHS exposures ranging from negligible up to >160 μg/m³ of PM_2.5. The average incremental exposure of the non‐smokers was higher indoors (42 μg/m³, n = 35) than outdoors (29 μg/m³, n = 47), but the overall indoor and outdoor frequency distributions were similar. The 10‐s PM_2.5 averages during the smoking periods showed great variability, with multiple high concentrations of short duration (microplumes) both indoors and outdoors.     

Personal exposure to PM2.5 in Chinese rural households in the Yangtze River Delta

High levels of PM_2.5 exposure and associated health risks are of great concern in rural China. For this study, we used portable PM_2.5 monitors for monitoring concentrations online, recorded personal time‐activity patterns, and analyzed the contribution from different microenvironments in rural areas of the Yangtze River Delta, China. The daily exposure levels of rural participants were 66 μg/m³ (SD 40) in winter and 65 μg/m³ (SD 16) in summer. Indoor exposure levels were usually higher than outdoor levels. The exposure levels during cooking in rural kitchens were 140 μg/m³ (SD 116) in winter and 121 μg/m³ (SD 70) in summer, the highest in all microenvironments. Winter and summer values were 252 μg/m³ (SD 103) and 204 μg/m³ (SD 105), respectively, for rural people using biomass for fuel, much higher than those for rural people using LPG and electricity. By combining PM_2.5concentrations and time spent in different microenvironments, we found that 92% (winter) and 85% (summer) of personal exposure to PM_2.5in rural areas was attributable to indoor microenvironments, of which kitchens accounted for 24% and 27%, respectively. Consequently, more effective policies and measures are needed to replace biomass fuel with LPG or electricity, which would benefit the health of the rural population in China.     

Air quality,mortality, and economic benefits of a smoke – free workplace law for non‐smoking Ontario bar workers

We estimated the impact of a smoke‐free workplace bylaw on non‐smoking bar workers' health in Ontario, Canada. We measured bar workers' urine cotinine before (n = 99) and after (n = 91) a 2004 smoke‐free workplace bylaw. Using pharmacokinetic and epidemiological models, we estimated workers' fine‐particle (PM_2.5) air pollution exposure and mortality risks from workplace secondhand smoke (SHS). workers' pre‐law geometric mean cotinine was 10.3 ng/ml; post‐law dose declined 70% to 3.10 ng/ml and reported work hours of exposure by 90%. Pre‐law, 97% of workers' doses exceeded the 90th percentile for Canadians of working age. Pre‐law‐estimated 8‐h average workplace PM_2.5 exposure from SHS was 419 μg/m³ or ‘Very Poor’ air quality, while outdoor PM_2.5 levels averaged 7 μg/m³, ‘Very Good’ air quality by Canadian Air Quality Standards. We estimated that the bar workers' annual mortality rate from workplace SHS exposure was 102 deaths per 100 000 persons. This was 2.4 times the occupational disease fatality rate for all Ontario workers. We estimated that half to two‐thirds of the 10 620 Ontario bar workers were non‐smokers. Accordingly, Ontario's smoke‐free law saved an estimated 5–7 non‐smoking bar workers' lives annually, valued at CA $50 million to $68 million (US $49 million to $66 million).     

Unexpected increase in indoor pollutants after the introduction of a smoke‐free policy in a correctional center

Correctional centers (prisons) are one of the few non‐residential indoor environments where smoking is still permitted. However, few studies have investigated indoor air quality (IAQ) in these locations. We quantified the level of inmate and staff exposure to secondhand smoke, including particle number (PN) count, and we assessed the impact of the smoking ban on IAQ. We performed measurements of indoor and outdoor PM_2.5 and PN concentrations, personal PN exposure levels, volatile organic compounds (VOCs), and nicotine both before and after a complete indoor smoking ban in an Australian maximum security prison. Results show that the indoor 24‐h average PM_2.5 concentrations ranged from 6 (±1) μg/m³ to 17 (±3) μg/m³ pre‐ban. The post‐ban levels ranged from 7 (±2) μg/m³ to 71 (±43) μg/m³. While PM_2.5 concentrations decreased in one unit post‐ban, they increased in the other two units. Similar post‐ban increases were also observed in levels of PN and VOCs. We describe an unexpected increase of indoor pollutants following a total indoor smoking ban in a prison that was reflected across multiple pollutants that are markers of smoking. We hypothesise that clandestine post‐ban smoking among inmates may have been the predominant cause.     

Coarse particulate matter and airborne endotoxin within wood stove homes

Emissions from indoor biomass burning are a major public health concern in developing areas of the world. Less is known about indoor air quality, particularly airborne endotoxin, in homes burning biomass fuel in residential wood stoves in higher income countries. A filter‐based sampler was used to evaluate wintertime indoor coarse particulate matter (PM_10‐2.5) and airborne endotoxin (EU/m³, EU/mg) concentrations in 50 homes using wood stoves as their primary source of heat in western Montana. We investigated number of residents, number of pets, dampness (humidity), and frequency of wood stove usage as potential predictors of indoor airborne endotoxin concentrations. Two 48‐h sampling events per home revealed a mean winter PM_10‐2.5 concentration (± s.d.) of 12.9 (± 8.6) μg/m³, while PM_2.5 concentrations averaged 32.3 (± 32.6) μg/m³. Endotoxin concentrations measured from PM_10‐2.5 filter samples were 9.2 (± 12.4) EU/m³ and 1010 (± 1524) EU/mg. PM_10‐2.5 and PM_2.5 were significantly correlated in wood stove homes (r = 0.36, P < 0.05). The presence of pets in the homes was associated with PM_10‐2.5 but not with endotoxin concentrations. Importantly, none of the other measured home characteristics was a strong predictor of airborne endotoxin, including frequency of residential wood stove usage.     

Household and behavioral determinants of indoor PM2.5 in a rural solid fuel burning Native American community

Indoor and outdoor concentrations of PM_2.5 were measured for 24 h during heating and non-heating seasons in a rural solid fuel burning Native American community. Household building characteristics were collected during the initial home sampling visit using technician walkthrough questionnaires, and behavioral factors were collected through questionnaires by interviewers. To identify seasonal behavioral factors and household characteristics associated with indoor PM_2.5, data were analyzed separately by heating and non-heating seasons using multivariable regression. Concentrations of PM_2.5 were significantly higher during the heating season (indoor: 36.2 μg/m³; outdoor: 22.1 μg/m³) compared with the non-heating season (indoor: 14.6 μg/m³; outdoor: 9.3 μg/m³). Heating season indoor PM_2.5 was strongly associated with heating fuel type, housing type, indoor pests, use of a climate control unit, number of interior doors, and indoor relative humidity. During the non-heating season, different behavioral and household characteristics were associated with indoor PM_2.5 concentrations (indoor smoking and/or burning incense, opening doors and windows, area of surrounding environment, building size and height, and outdoor PM_2.5). Homes heated with coal and/or wood, or a combination of coal and/or wood with electricity and/or natural gas had elevated indoor PM_2.5 concentrations that exceeded both the EPA ambient standard (35 μg/m³) and the WHO guideline (25 μg/m³).     

Assessing exposure to secondhand smoke in restaurants and bars 2 years after the smoking regulations in Beijing,China

Field observation of patron smoking behaviors and multiple sampling approaches were conducted in 79 restaurants and bars in Beijing, 2010, 2 years after implementing the governmental smoking regulations. Smoking was observed in 30 visits to 22 of the 37 nominal non‐smoking venues during peak patronage times and six visits to four of the 14 nominal non‐smoking sections. The median area secondhand smoke (SHS) concentrations during peak patronage time were 27, 15, 43, and 40 μg/m³ in nominal non‐smoking venues, non‐smoking sections, smoking sections, and smoking venues, respectively, as indicated by the difference between indoor and outdoor PM_2.5 levels; and 1.4, 0.6, 1.7, and 2.7 μg/m³, respectively, as indicated by airborne nicotine. In the 27 venues with sampling of different approaches and over different time periods, the median nicotine concentration was 1.8 μg/m³ by one‐hour peak patronage‐time sampling, 1.1 μg/m³ by 1‐day active area sampling, 2.5 μg/m³ by 1‐day personal sampling, and 2.3 μg/m³ by week‐long passive sampling. No significant differences in nicotine levels were observed among venues/sections with different nominal smoking policies by all sampling approaches except during peak patronage time. This study showed that the 2008 Beijing governmental smoking restriction has been poorly implemented, and SHS exposures in Beijing restaurants and bars remain high.     

Fine and ultrafine particle exposures on 73 trips by car to 65 non‐smoking restaurants in the San Francisco Bay Area

A number of studies indicate cooking is a major source of exposure to particulate matter, but few studies have measured indoor air pollution in restaurants, where cooking predominates. We made 73 visits by car to 65 different non‐smoking restaurants in 10 Northern California towns while carrying portable continuous monitors that unobtrusively measured ultrafine (down to 10 nm) and fine (PM_2.5) particles to characterize indoor restaurant exposures, comparing them with exposures in the car. The mean ultrafine number concentrations in the restaurants on dinner visits averaging 1.4 h was 71 600 particles/cm³, or 4.3 times the mean concentration on car trips, and 12.3 times the mean background concentration in the residence. Restaurants that cooked dinner in the same room as the patrons had higher ultrafine concentrations than restaurants with separate kitchens. Restaurant PM_2.5 mass concentrations averaged 36.3 μg/m³, ranging from 1.5 to 454 μg/m³, but were relatively low on most visits: 43% of the indoor means were below 10 μg/m³ and 66% were below 20 μg/m³, with 5.5% above 100 μg/m³. Exposure to fine and ultrafine particles when visiting a restaurant exceeded the exposure a person received while traveling by car to and from the restaurant.     

Particle characterization in retail environments: concentrations,sources, and removal mechanisms

Particles in retail environments can have consequences for the occupational exposures of retail workers and customers, as well as the energy costs associated with ventilation and filtration. Little is known about particle characteristics in retail environments. We measured indoor and outdoor mass concentrations of PM₁₀ and PM_2.5, number concentrations of submicron particles (0.02–1 μm), size‐resolved 0.3–10 μm particles, as well as ventilation rates in 14 retail stores during 24 site visits in Pennsylvania and Texas. Overall, the results were generally suggestive of relatively clean environments when compared to investigations of other building types and ambient/occupational regulatory limits. PM₁₀ and PM_2.5 concentrations (mean ± s.d.) were 20 ± 14 and 11 ± 10 μg/m³, respectively, with indoor‐to‐outdoor ratios of 1.0 ± 0.7 and 0.88 ± 1.0. Mean submicron particle concentrations were 7220 ± 7500 particles/cm³ with an indoor‐to‐outdoor ratio of 1.18 ± 1.30. The median contribution to PM₁₀ and PM_2.5 concentrations from indoor sources (vs. outdoors) was 83% and 53%, respectively. There were no significant correlations between measured ventilation rates and particle concentrations of any size. When examining options to lower PM_2.5 concentrations below regulatory limits, the required changes to ventilation and filtration efficiency were site specific and depended on the indoor and outdoor concentration, emission rate, and infiltration level.     

Kerosene lighting contributes to household air pollution in rural Uganda

The literature on the contribution of kerosene lighting to indoor air particulate concentrations is sparse. In rural Uganda, kitchens are almost universally located outside the main home, and kerosene is often used for lighting. In this study, we obtained longitudinal measures of particulate matter 2.5 microns or smaller in size (PM_2.5) from living rooms and kitchens of 88 households in rural Uganda. Linear mixed‐effects models with a random intercept for household were used to test the hypotheses that primary reported lighting source and kitchen location (indoor vs outdoor) are associated with PM_2.5 levels. During initial testing, households reported using the following sources of lighting: open‐wick kerosene (19.3%), hurricane kerosene (45.5%), battery‐powered (33.0%), and solar (1.1%) lamps. During follow‐up testing, these proportions changed to 29.5%, 35.2%, 18.2%, and 9.1%, respectively. Average ambient, living room, and kitchen PM_2.5 levels were 20.2, 35.2, and 270.0 μg/m³. Living rooms using open‐wick kerosene lamps had the highest PM_2.5 levels (55.3 μg/m³) compared to those using solar lighting (19.4 μg/m³; open wick vs solar, P=.01); 27.6% of homes using open‐wick kerosene lamps met World Health Organization indoor air quality standards compared to 75.0% in homes using solar lighting.     

Exercise‐induced effects on a gym atmosphere

We report results of analysis of a month‐long measurement of indoor air and environment quality parameters in one gym during sporting activities such as football, basketball, volleyball, badminton, boxing, and fitness. We have determined an average single person's contribution to the increase of temperature, humidity, and dust concentration in the gym air volume of 12500 m³: during 90‐min exercise performed at an average heart rate of 143 ± 10 bpm, a single person evaporated 0.94 kg of water into the air by sweating, contributed 0.03 K to the air temperature rise and added 1.5 μg/m³ and 5 ng/m³ to the indoor concentration of inhalable particles (PM₁₀) and Ca concentration, respectively. As the breathing at the observed exercise intensity was about three times faster with respect to the resting condition and as the exercise‐induced PM₁₀ concentration was about two times larger than outdoors, a sportsman in the gym would receive about a sixfold higher dose of PM₁₀ inside than he/she would have received at rest outside.     

Electrostatic dust collectors compared to inhalable samplers for measuring endotoxin concentrations in farm homes

Paired electrostatic dust collectors (EDCs) and daily, inhalable button samplers (BS) were used concurrently to sample endotoxin in 10 farm homes during 7‐day periods in summer and winter. Winter sampling included an optical particle counter (OPC) to measure PM_2.5 and PM_2.5–10. Electrostatic dust collectors and BS filters were analyzed for endotoxin using the kinetic chromogenic Limulus amebocyte lysate assay. Optical particle counter particulate matter (PM) data were divided into two PM categories. In summer, geometric mean (geometric standard deviation) endotoxin concentrations were 0.82 EU/m³ (2.7) measured with the BS and 737 EU/m² (1.9) measured with the EDC. Winter values were 0.52 EU/m³ (3.1) for BS and 538 EU/m² (3.0) for EDCs. Seven‐day endotoxin values of EDCs were highly correlated with the 7‐day BS sampling averages (r = 0.70; P < 0.001). Analysis of variance indicated a 2.4‐fold increase in EDC endotoxin concentrations for each unit increase of the ratio of PM_2.5 to PM_2.5–10. There was also a significant correlation between BS and EDCs endotoxin concentrations for winter (r = 0.67; P < 0.05) and summer (r = 0.75; P < 0.05). Thus, EDCs sample comparable endotoxin concentrations to BS, making EDCs a feasible, easy to use alternative to BS for endotoxin sampling.     

Exposure to fine particulate matter in ten night clubs in Athens Greece: Studying the effect of ventilation, cigarette smoking and resuspension

The aim of the present work is to study the occupants' exposure to fine particulate concentrations in ten nightclubs (NCs) in Athens, Greece. Measurements of PM₁ and PM_2.5 were made in the outdoor and indoor environment of each NC. The average indoor PM₁ and PM_2.5 concentrations were found to be 181.77 μg m^− 3 and 454.08 μg m^− 3 respectively, while the corresponding outdoor values were 11.04 μg m^− 3 and 32.19 μg m^− 3. Ventilation and resuspension rates were estimated through consecutive numerical experiments with an indoor air quality model and were found to be remarkably lower than the minimum values recommended by national standards. The relative effects of the ventilation and smoking on the occupants' exposures were examined using multiple regression techniques. It was found that given the low ventilation rates, the effect of smoking as well as the occupancy is of the highest importance. Numerical evaluations showed that if the ventilation rates were at the minimum values set by national standards, then the indoor exposures would be reduced at the 70% of the present exposure values.     

Indoor exposure to particulate matter and the incidence of acute lower respiratory infections among children: A birth cohort study in urban Bangladesh

Approximately half of all children under two years of age in Bangladesh suffer from an acute lower respiratory infection (ALRI) each year. Exposure to indoor biomass smoke has been consistently associated with an increased risk of ALRI in young children. Our aim was to estimate the effect of indoor exposure to particulate matter (PM_2.5) on the incidence of ALRI among children in a low‐income, urban community in Bangladesh. We followed 257 children through two years of age to determine their frequency of ALRI and measured the PM_2.5 concentrations in their sleeping space. Poisson regression was used to estimate the association between ALRI and the number of hours per day that PM_2.5 concentrations exceeded 100 μg/m³, adjusting for known confounders. Each hour that PM_2.5 concentrations exceeded 100 μg/m³ was associated with a 7% increase in incidence of ALRI among children aged 0–11 months (adjusted incidence rate ratio (IRR) 1.07, 95% CI 1.01–1.14), but not in children 12–23 months old (adjusted IRR 1.00, 95% CI 0.92–1.09). Results from this study suggest that reducing indoor PM_2.5 exposure could decrease the frequency of ALRI among infants, the children at highest risk of death from these infections.     

Characterizing peak exposure of secondhand smoke using a real-time PM2.5 monitor

Although short-duration elevated exposures (peak exposures) to pollutants may trigger adverse acute effects, epidemiological studies to understand their influence on different health effects are hampered by lack of methods for objectively identifying peaks. Secondhand smoke from cigarettes (SHS) in the residential environment can lead to peak exposures. The aim of this study was to explore whether peaks in continuous PM_2.5 data can indicate SHS exposure. A total of 41 children (21 with and 20 without SHS exposure based on self-report) from 28 families in New York City (NY, USA) were recruited. Both personal and residential continuous PM_2.5 monitoring were performed for five consecutive days using MicroPEM sensors (RTI International, USA). A threshold detection method based on cumulative distribution function was developed to identify peaks. When children were home, the mean accumulated peak area (APA) for peak exposures was 297 ± 325 hour*µg/m³ for children from smoking families and six times that of the APA from non-smoking families (~50 ± 54 hour*µg/m³). Average PM_2.5 mass concentrations for SHS exposed and unexposed children were 24 ± 15 µg/m³ and 15 ± 9 µg/m³, respectively. The average SHS exposure duration represents ~5% of total exposure time, but ~13% of children's total PM_2.5 exposure dose, equivalent to an additional 2.6 µg/m³ per day. This study demonstrated the feasibility of peak analysis for quantifying SHS exposure. The developed method can be adopted more widely to support epidemiology studies on impacts of short-term exposures.     

Indoor air quality and thermal comfort in temporary houses occupied after the Great East Japan Earthquake

Thermal conditions and indoor concentrations of aldehydes, volatile organic compounds (VOCs), and NO₂ were investigated in 19 occupied temporary houses in 15 temporary housing estates constructed in Minamisoma City, Fukushima, Japan. The data were collected in winter, spring, and summer in January to July 2012. Thermal conditions in temporary log houses in the summer were more comfortable than those in pre‐fabricated houses. In the winter, the indoor temperature was uncomfortably low in all of the houses, particularly the temporary log houses. Indoor air concentrations for most aldehydes and VOCs were much lower than the indoor guidelines, except for those of p‐dichlorobenzene, acetaldehyde, and total VOCs. The indoor p‐dichlorobenzene concentrations exceeded the guideline (240 μg/m³) in 18% of the temporary houses, and the 10^?3 cancer risk level (91 μg/m³) was exceeded in winter in 21% due to use of moth repellents by the occupants. Indoor acetaldehyde concentrations exceeded the guideline (48 μg/m³) in about half of the temporary houses, likely originating from the wooden building materials. Indoor NO₂ concentrations in the temporary houses were significantly higher in houses where combustion heating appliances were used (0.17 ± 0.11 ppm) than in those where they were not used (0.0094 ± 0.0065 ppm).     

Impact of neighborhood biomass cooking patterns on episodic high indoor particulate matter concentrations in clean fuel homes in Dhaka,Bangladesh

Exposure to particulate matter (PM_2.5) from the burning of biomass is associated with increased risk of respiratory disease. In Dhaka, Bangladesh, households that do not burn biomass often still experience high concentrations of PM_2.5, but the sources remain unexplained. We characterized the diurnal variation in the concentrations of PM_2.5 in 257 households and compared the risk of experiencing high PM_2.5 concentrations in biomass and non‐biomass users. Indoor PM_2.5 concentrations were estimated every minute over 24 h once a month from April 2009 through April 2010. We found that households that used gas or electricity experienced PM_2.5 concentrations exceeding 1000 μg/m³ for a mean of 35 min within a 24‐h period compared with 66 min in biomass‐burning households. In both households that used biomass and those that had no obvious source of particulate matter, the probability of PM_2.5 exceeding 1000 μg/m³ were highest during distinct morning, afternoon, and evening periods. In such densely populated settings, indoor pollution in clean fuel households may be determined by biomass used by neighbors, with the highest risk of exposure occurring during cooking periods. Community interventions to reduce biomass use may reduce exposure to high concentrations of PM_2.5 in both biomass and non‐biomass using households.     

Polycyclic aromatic hydrocarbons: levels and phase distributions in preschool microenvironment

This work aims to characterize levels and phase distribution of polycyclic aromatic hydrocarbons (PAHs) in indoor air of preschool environment and to assess the impact of outdoor PAH emissions to indoor environment. Gaseous and particulate (PM₁ and PM_2.5) PAHs (16 USEPA priority pollutants, plus dibenzo[a,l]pyrene, and benzo[j]fluoranthene) were concurrently sampled indoors and outdoors in one urban preschool located in north of Portugal for 35 days. The total concentration of 18 PAHs (ΣPAHs) in indoor air ranged from 19.5 to 82.0 ng/m³; gaseous compounds (range of 14.1–66.1 ng/m³) accounted for 85% ΣPAHs. Particulate PAHs (range 0.7–15.9 ng/m³) were predominantly associated with PM₁ (76% particulate ΣPAHs) with 5‐ring PAHs being the most abundant. Mean indoor/outdoor ratios (I/O) of individual PAHs indicated that outdoor emissions significantly contributed to PAH indoors; emissions from motor vehicles and fuel burning were the major sources.     

A comparative study of human exposures to household air pollution from commonly used cookstoves in Sri Lanka

Solid fuel burning cookstoves are a major source of household air pollution (HAP) and a significant environmental health risk in Sri Lanka. We report results of the first field study in Sri Lanka to include direct measurements of both real‐time indoor concentrations and personal exposures of fine particulate matter (PM_2.5) in households using the two most common stove types in Sri Lanka. A purposive sample of 53 households was selected in the rural community of Kopiwatta in central Sri Lanka, roughly balanced for stove type (traditional or improved ‘Anagi’) and ventilation (chimney present or absent). At each household, 48‐h continuous real‐time measurements of indoor kitchen PM_2.5 and personal (primary cook) PM_2.5 concentrations were measured using the RTI MicroPEM^? personal exposure monitor. Questionnaires were used to collect data related to household demographics, characteristics, and self‐reported health symptoms. All primary cooks were female and of an average age of 47 years, with 66% having completed primary education. Median income was slightly over half the national median monthly income. Use of Anagi stoves was positively associated with a higher education level of the primary cook (P = 0.026), although not associated with household income (P = 0.18). The MicroPEM monitors were well‐received by participants, and this study's valid data capture rate exceeded 97%. Participant wearing compliance during waking hours was on average 87.2% on Day 1 and 83.3% on Day 2. Periods of non‐compliance occurred solely during non‐cooking times. The measured median 48‐h average indoor PM_2.5 concentration for households with Anagi stoves was 64 μg/m³ if a chimney was present and 181 μg/m³ if not. For households using traditional stoves, these values were 70 μg/m³ if a chimney was present and 371 μg/m³ if not. Overall, measured indoor PM_2.5 concentrations ranged from a minimum of 33 μg/m³ to a maximum of 940 μg/m³, while personal exposure concentrations ranged from 34 to 522 μg/m³. Linear mixed effects modeling of the dependence of indoor concentrations on stove type and presence or absence of chimney showed a significant chimney effect (65% reduction; P < 0.001) and an almost significant stove effect (24% reduction; P = 0.054). Primary cooks in households without chimneys were exposed to substantially higher levels of HAP than those in households with chimneys, while exposures in households with traditional stoves were moderately higher than those with improved Anagi stoves. As expected, simultaneously measuring both indoor concentrations and personal exposure levels indicate significant exposure misclassification bias will likely result from the use of a stationary monitor as a proxy for personal exposure. While personal exposure monitoring is more complex and expensive than deploying simple stationary devices, the value an active personal PM monitor like the MicroPEM adds to an exposure study should be considered in future study designs.     

Chimney stoves modestly improved Indoor Air Quality measurements compared with traditional open fire stoves: results from a small‐scale intervention study in rural Peru

Nearly half of the world's population depends on biomass fuels to meet domestic energy needs, producing high levels of pollutants responsible for substantial morbidity and mortality. We compare carbon monoxide (CO) and particulate matter (PM_2.5) exposures and kitchen concentrations in households with study‐promoted intervention (OPTIMA‐improved stoves and control stoves) in San Marcos Province, Cajamarca Region, Peru. We determined 48‐h indoor air concentration levels of CO and PM_2.5 in 93 kitchen environments and personal exposure, after OPTIMA‐improved stoves had been installed for an average of 7 months. PM_2.5 and CO measurements did not differ significantly between OPTIMA‐improved stoves and control stoves. Although not statistically significant, a post hoc stratification of OPTIMA‐improved stoves by level of performance revealed mean PM_2.5 and CO levels of fully functional OPTIMA‐improved stoves were 28% lower (n = 20, PM_2.5, 136 μg/m³ 95% CI 54–217) and 45% lower (n = 25, CO, 3.2 ppm, 95% CI 1.5–4.9) in the kitchen environment compared with the control stoves (n = 34, PM_2.5, 189 μg/m³, 95% CI 116–261; n = 44, CO, 5.8 ppm, 95% CI 3.3–8.2). Likewise, although not statistically significant, personal exposures for OPTIMA‐improved stoves were 43% and 17% lower for PM_2.5 (n = 23) and CO (n = 25), respectively. Stove maintenance and functionality level are factors worthy of consideration for future evaluations of stove interventions.